Friday, January 20, 2017

On the stigma of psychoanalysis and psychotherapy in the Arab world

Artwork by Tarek Chemaly
In 2003 I did a psychotherapy. At the end of the 12 sessions required for the psychotherapist asked me if I wished to go on. And I did, up to 21 sessions including the stabilization one. It might be one of the best investments I ever did in my life.
Psychotherapy and psychoanalysis are not covered by social security so if one is to do them, one has to do them at one's own expense. Each session lasts 45 minutes ad usually, they are at very assigned times (same time, same day) and at the rate of one session per week, unless intensive one requires two per week.
But there is a huge stigma associated with either psychotherapy or psychoanalysis. And that one is that they are only for people who are "nuts". The stigma engulfs all socio-economic classes, all religions as well in Lebanon - and certainly in the Arab world at large.
Perhaps women patients are less criticized but for the men, the social idea is that - if you resort to psychotherapy or psychoanalysis then you are not "man enough" to "handle your own problems" (and this is a direct quote that was said to me and the person who said it is a very educated, and wealthy man who works as an upper executive in a multinational).
There are of course, other issues to the stigma. First, is that, in Arab countries at large - how you are and what happens to you is an act of God. Trying to change that is obviously a way to challenge "el maktoub" (what is written - as believed by the Muslim part) or "God's plan" (as the Christian part would say). And of course, believing that whatever happens to you, or the way you are, it was an act of God also brings the side notion of "punishment" (ergo - God is punishing you for having done something bad, so you ended up with anger management issues, or with a depression or whatever).
It is not uncommon for people to visit a religious figure in the Arab world and going to a therapist or anaylist as a "final resort". The word jnoon (or folly-crazyness) is derived from "jinni" or evil spirit, meaning the person has been inhabited by an evil spirit and that there is fundamentally nothing wrong with him/her and all it takes is for a religious entity to take the spirit out. Naturally, going to a sheikh or priest carries much less stigma than admitting to some neurological or personal dysfunction.
So, between throwing doubt at one's mental health, between doubting one's own strength of character to handle one's own problems (and in extenso one's "masculinity"), and eventually the notion that to try to change anything is a pure defiance of God's will/plan; this means that counseling or therapy or analysis are majorly frowned upon.
The Lebanese population, having suffered one major and other less major wars, has been under incredible duress - one that has given them mental consequences which endure and which, them now being parents, affects their behavior towards their children and may transmit subconsciously, certain traits to the new generation (which mind you, may have suffered their own war - such as the 2006 one).
As I said earlier, psychotherapy, if one is willing to undergo it with an open mind - is exceptionally helpful. One does it, not just for one's self, but also on behalf of family, friends, and partners. Whereas I understand not everyone has the means to pay for it or the will to do it (as it requires one to be open and forthcoming which is, understandably, not always the case), and that those who end up doing it end up stigmatized (as "nuts", not manly enough or challengers of God's will/plan), it is still an incredible tool. since it empowers, it strengthens, and eventually emancipates the patient.

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